One of the most frustrating aspects of IVF treatment is the unsuccessful cycle where everything looks perfect, but the pregnancy test is negative. When patients are older, the likely cause of failure is age-related chromosomal abnormalities commonly found in embryos in women in their 40’s. Younger women can also have abnormal embryos, which can be detected by Pre-implantation Genetic Testing (PGT), but often the continued failures occur even with normal embryos.
Often, implantation failures are treated as recurrent miscarriages, but there is no evidence that the two are related. Physicians have treated with a host of remedies, ranging from simple and safe to outrageous and dangerous. The use of unproven tests, largely on the immune system, has generally been associated with expensive, questionable treatments that lead nowhere.
Uterine abnormalities or chromosomal structural abnormalities are definitive causes, which can be addressed with surgery or Pre-implantation Genetic Disorders (PGD). Immune and clotting factors have been associated with recurrent losses, but treatment for them seems to yield results that are no better than random success in many cases.
The road often leads to the use of a gestational carrier, which no one really wants to do, even if they can afford it. However, because there is no good way to determine why an embryo fails to implant, or implants and fails to continue, many physicians will use empiric therapy out of helplessness until the patient's luck turns. Or doesn't.
One of the few legitimate hopes for patients is an investigational medicine called NT100, a Granulocyte-Colony Stimulating Factor (G-CSF), now being studied at Nora Therapeutics, based in Palo Alto, Calif. In limited studies, G-CSF has been shown to improve the implantation and ongoing pregnancy rates in patients with unexplained recurrent failures.
Nora’s Thrive-IVF study at several prominent IVF centers, including Fertility Centers of Illinois in Chicago, provides an IVF cycle at no cost if the patient qualifies and is willing to participate in the study. You may be eligible to participate in the Thrive-IVF study if you are between ages 21 and 38 and have had three or more failed IVF cycles that include transfer of good-quality embryos (at least two of these involving the transfer of fresh embryos). If you participate in the study, you will be required to make about 11 clinic visits. If you are interested, please visit www.thriveivf.com/univfy.